Cancer medicines unaffordable for patients, doctors say

Cancer medicines that cost more than $100,000 a year aren't morally justifiable and may keep patients from getting life-saving treatments, a group of more than 100 leukemia doctors said.

Of the 12 cancer medications approved by the Food and Drug Administration last year, 11 cost more than $100,000 annually, the physicians said in an article in Blood, the journal of the American Society of Hematology, published online Thursday.

The paper highlights the debate over how much leeway drugmakers should have in setting the prices of new cancer medicines and whether pricing practices harm patients and health-care systems. While companies should be allowed to profit, a product that can help a patient survive should be priced affordably, the cancer specialists said.

"Hopes that the fundamentals of a free market economy and market competition will settle cancer drug prices at lower levels have not been fulfilled," the doctors said in the paper.

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Drugmakers said they charge prices for their treatments that were lower than those quoted in the article and pointed to assistance programs provided to help patients afford their medications.

Pfizer Inc., whose leukemia medicine Bosulif was approved in December and priced about $98,000, helps financially eligible patients get their prescriptions for free or at a savings, and insured patients pay no more than $50 a month, said Victoria Davis, a spokeswoman for New York-based Pfizer, the world's biggest drugmaker. The article said Bosulif costs $118,000 annually.

"We wholeheartedly agree that patients should have access to the medications they need and Pfizer has developed various programs to support CML patients gaining access to Bosulif," Davis said.

The paper was written by doctors who are specialists in chronic myeloid leukemia, which accounts for about 10 percent of the 48,610 new leukemia cases estimated by the National Cancer Institute. The survival rate hovers about 60 percent for the disease in the United States, compared with 80 percent in Sweden. Costs in Sweden are managed and patients may be more likely to comply with treatment while they don't have the same cost concerns as U.S. patients, the doctors said.

"We believe that lowering the prices of CML drugs might improve accessibility to treatment and increase treatment adherence, Hagop Kantarjian, chairman of the leukemia department at The University of Texas MD Anderson Cancer Center and an author of the paper, said in a statement. Reducing the prices would increase the number of patients who live longer because they would be able to continue on the medications, known as tyrosine kinase inhibitors, he said.

Tyrosine kinase inhibitors, which also include medicines such as Novartis AG's Gleevec and Ariad Pharmaceuticals Inc.'s Iclusig, have helped reduced mortality to 2 percent versus 10 to 20 percent in the early 2000s, the doctors said.

There are expected to be 5,920 new cases and 610 deaths from chronic myeloid leukemia in the U.S. this year, according to the American Cancer Society. Chronic myeloid leukemia is one of the four main types of leukemia in adults. The disease is a slowly progressing blood and bone marrow disease that rarely occurs in children, according to the National Cancer Institute.

Gleevec, the standard treatment for chronic myeloid leukemia patients, started off at a price of $30,000 a year when it was approved in 2001 and has tripled in cost, the doctors wrote.

The majority of U.S. patients pay less than $100 out of pocket per month for Gleevec, according to a statement from Basel, Switzerland-based Novartis. The company also gave Gleevec or its other chronic myeloid leukemia treatment Tasigna free to an average of 5,000 uninsured or underinsured patients every year for the last five years, Novartis said.

Ariad's Iclusig, approved in December for the disease, costs about $115,000 a year, the Cambridge, Massachusetts-based company said. The article pegs the price at $138,000 annually.

Teva Pharmaceutical Industries Ltd. also has a patient assistance program for its drug, Synribo, to treat the disease, Denise Bradley, a spokeswoman for Petach Tikva, Israel-based Teva, said in an e-mail.

The doctors said regular meetings should be scheduled to discuss the societal and political issues that affect drug pricing.